A day after leading a roundtable discussion in Washington C.H. on the heroin/opioid addiction crisis, U.S. Sen. Sherrod Brown (D-OH) applauded actions taken by President Obama’s administration Tuesday that will expand access to treatment for opioid addiction across the country, including medication-assisted treatment.
Brown recently introduced the Heroin and prescription Drug Abuse Prevention and Reduction Act, which he said is a comprehensive approach to address the spectrum of addiction. He is also the co-sponsor of The Recovery Enhancement for Addiction Treatment Act, which would help increase access to medication-assisted treatment.
“Tackling the opioid epidemic requires a comprehensive approach – from prevention to treatment to recovery,” Brown said. “(Tuesday’s) announcement marks a major step toward ensuring all individuals have access to the treatment they need, including effective medication-assisted treatment. By doubling the number of patients that can be seen by a qualified physician, I’m hopeful fewer will have to wait for months to get the help they need.”
Monday’s roundtable discussion at the Fayette County Health Department, which included local leaders and public health officials, clearly articulated that heroin/opioid addiction has had a dramatic impact on many facets of the local community, including safety, health, education, employment, housing and the overall perception of Washington C.H. and Fayette County.
During the local health department’s community health assessment that included surveys and forums, the number one issue/concern by far in the community is drug abuse, according to Leigh Cannon, deputy health commissioner.
“That obviously is not a shock to anyone,” said Cannon. “From a public health perspective, we’ve seen an increase in hepatitis C cases just in the last year due to heroin use.”
Cannon said that the health department is working to obtain a grant for the availability of Project DAWN (Deaths Avoided With Naloxone), a community-based overdose education and naloxone distribution program. Those who have a relative or loved one who is addicted to heroin could receive training on: recognizing the signs and symptoms of overdose, distinguishing between different types of overdose, performing rescue breathing, calling emergency medical services, and administering intranasal Naloxone.
Naloxone, also known as Narcan, is a medication that can reverse an overdose caused by an opioid drug (heroin or prescription pain medications). When administered during an overdose, naloxone blocks the effects of opioids on the brain and quickly restores breathing.
“We are also working very diligently on getting Vivitrol,” said Cannon. “We’re hoping that by June we can launch that program. It’s an injection and the patient would have to pass a drug test and go through counseling in order to get it.”
Vivitrol blocks the effects of opioid medication, including pain relief or feelings of well-being that can lead to opioid abuse. It is used as part of a treatment program for drug or alcohol dependence.
During Monday’s discussion, Joshua Wiseman and Jonathan Bennett from Pickaway Area Recovery Services were in attendance to offer their perspectives. The organization operates women’s residential centers in Circleville and Washington C.H.
“Heroin is instant gratification,” said Wiseman. “But addiction is addiction. There are some people who can drink on occasion and be perfectly fine. But there are certain people who have a certain disposition or genes that make them more likely to become an addict. If you have an addiction somewhere in your family, yes you are more susceptible. So when you use heroin that first time, you will become addicted.”
Pickaway Area Recovery Services currently holds a 40 percent success rate for addicts that participate in the treatment program, according to Wiseman. The national average is below 10 percent.
“We go by evidence-based material,” said Wiseman. “The first thing we teach is scheduling. Most drug addicts out there, they don’t schedule. They wake up in the morning seeking their drugs. It’s very important for them to keep their day occupied. From there, it’s separating people, places and things. We’re empowering the clients to use these skills. Coping mechanisms, realizing what your triggers are….all of these things come into play.”
The lack of transitional housing within the community can contribute to the relapse of addicts.
“Once they leave our facility and they have to go back to mom and dad, who they might have been using with, that becomes problematic,” said Wiseman. “So transitional housing is a key component to this to make it successful in the long-term. That’s another thing that we’re trying to incorporate, but there is sometimes a struggle with the community, who say they don’t want this in their back yard. They say to put it in a big field somewhere in the county. That’s not working. Cows don’t need treatment. These people need to be integrated into the community. We need to get them jobs, and transitional housing is a big key to that.”
Potential employees being unable to pass drug tests for local businesses has become commonplace in the community, according to Fayette County Chamber of Commerce President Whitney Gentry.
“In visits with major manufacturers, the problem consistently is having a viable workforce,” said Gentry. “Being able to pass a drug test, pass a proficiency test and then having the desire to work. Not all of that is necessarily drug-related, but with as prevalent as the problem is and how cheap it is to get the drug, it’s obviously a component. We do have employers who are willing to hire folks with a felony conviction.”
Fayette County Commissioner Dan Dean agreed with Gentry’s assessment.
“We have 200 to 300 jobs that would pay $14 to $16 an hour that are unfilled in Fayette County,” said Dean. “The only requirement is that they are able to come to work, pass a drug test and ninth grade proficiency in some cases. Now, some of these employers are willing to hire low level felons, ones that have come through a program and are now clean. If we can get these folks to a certain point, we can have employment for them here.”
Although the two women’s treatment facilities have been successful, the lack of a men’s treatment center has been a hindrance to the recovery of many in the community. Community leaders are working diligently to rectify the situation.
“In the past year or so, our governor passed the Medicaid expansion, so now men have this available to them,” said Dean. “We as a community have recognized this problem for a couple years and for the last 18 months, city council, county commissioners, Community Action, Barry Bennett (the executive director of Pickaway Area Recovery Services) and his group, the Health Department, our law enforcement, our judges and our probation department have been meeting on a monthly basis. We’re now at a point where we feel like we can pay for the facility and keep it operating after we get it up. But we’re having trouble coming up with the capital basically – about a half a million dollars – to get the system up and going. We’re bending everyone’s ear to get this done.”
Washington C.H. City Manager Joe Denen expressed a similar sentiment from the city’s perspective. “Certainly when we talk to folks in the industrial park, I can’t fail to reinforce what Whitney told you about the availability of jobs that people can make a career and a nice lifestyle out of,” said Denen. “These are jobs with benefits, insurance, vacation…things you hear in the news don’t exist anymore. There is certainly a gap in how we’re dealing with this problem. If you’re arresting these folks, then you need a system in place that deals with them from that point on.”
Bambi Baughn, executive director of the Community Action Commission (CAC) of Fayette County, said CAC is attempting to assist with a men’s facility. “If we could convert some of our operating money to cover recovery housing and possibly get some housing vouchers that could be converted from the Housing Authority’s housing choice program to project-based, the combination of the rent assistance and the operating money could keep a facility going,” she said. “In fact, the state has $370,000 designated for Fayette County to construct or rehab housing for recovery housing. It has to be matched 100 percent and then you have to show how you’re going to operate it.”
From a local education point of view, the heroin problem is ubiquitous.
“It’s incredible how many kids we have in school from kindergarten to fifth grade whose parents are drug addicts,” said Washington City Schools Superintendent Matthew McCorkle. “(The parents) aren’t available, you can’t get ahold of them…..they’re not home. It’s about once a week we get a phone call from a bus driver who can’t drop two kids off because no one is home. And then if someone finally wakes up, you know you’re handing a kid over to someone who is sleeping off a high. You’re putting that kid in a position down the road where they’re going to get caught in that cycle.”
According to Brown, on Tuesday the Obama administration moved to:
– Increase the number of patients for qualified physicians who prescribe buprenorphine to treat opioid use. The Department of Health and Human Services (HHS) issued a proposed rule to increase the number of patients from 100 to 200, which will help expand treatment access and MAT.
– Strengthen mental health parity within Medicaid. HHS is finalizing a rule to require Medicaid and the Children’s Health Insurance Program (CHIP) to offer mental health and substance abuse treatment comparable to medical and surgical benefits.
In connection with Tuesday’s announcement, 60 medical schools – including Ohio State University and Ohio University – will require medical students to take prescriber education courses in line with the Center for Disease Control and Prevention’s new guidelines for prescribing opioids.
Reach Ryan Carter at 740-313-0352 or on Twitter @rywica.